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Durbin says US unprepared for lingering military mental health challenges

By Chuck RaaschSt. Louis Post-Dispatch(MCT)

WASHINGTON —The Army’s mental health caseload has doubled since 2007, and Sen. Dick Durbin says the United States is not “up to that challenge” that “may be with us for some time.”

“What we are learning,” the Illinois Democrat said in an interview, “is that the cost of war goes way beyond the end of conflict.”

The mass shooting at Fort Hood in Texasthis month, in which Army Spc. Ivan Lopez killed three fellow soldiers and wounded 16 others before taking his own life, brought back into focus the mental health strains on soldiers, sailors and Marines in the wars in Iraq and Afghanistan. Lopez had served in Iraq and had sought treatment for post-traumatic stress, the base commander told reporters.

Lopez’s attack came less than five years after Major Nidal Malik Hasan killed 13 and wounded 32 in a 2009 rampage at the same military installation. He has been sentenced to death.

Congress and the Pentagon have been struggling to provide resources and focus to address the problem of mental health among military veterans. Army spending on mental health has gone from $322.6 million in fiscal year 2013 to $358.4 million in the current year, with just under $375 million requested for next year.

Although Durbin said “we may never know” what provoked Lopez to turn his gun on fellow soldiers, the shock is especially deep because improved prevention and treatment programs at Fort Hood had given the base one of the best reputations on mental health treatment in the military.

“It was considered one of the leaders when it came to providing this kind of counseling, and unfortunately, even its resources couldn’t stop this tragedy,” Durbin said.

Even before this latest Fort Hood shooting, Congress was trying to confront expanding needs in civilian mental health care, prompted in part by a mass shooting at Sandy Hook Elementary School in Newtown, Conn., in 2012, in which 20 children and six adults died.

Congress approved this month and President Barack Obama signed into law a pilot program pushed by Sen. Roy Blunt, R-Mo.,that will make federal funds available to states willing to expand mental health services at clinics. It also encourages treatment of mental health in tandem with physical health. Eight states will test the program, and Blunt said that Missouri could be one of them.

“This is a huge step in the right direction because it does begin to talk about the totality of health as opposed to mental health as somehow a different topic,” Blunt said. He said experts have told him that 1 in 4 Americans has some form of mental health issues.

At a Senate Appropriations Committee hearing on Pentagon health programs, Army Surgeon General Patricia Horoho told Blunt that that she believes the same estimate applies to members of the military.

The Army thought it was making progress in dealing with its rising caseload before the new round of horrific headlines came out of Fort Hood.

Horoho said in a Senate appropriations subcommittee hearing that while the number of “behavioral health care” encounters between Army personnel or their families and mental health doctors and other professionals rose from 900,000 in 2007 to almost 2 million in 2013, there also was a significant drop last year in the number of days that Army personnel were hospitalized in cases related to mental health.

The Army changed the way it asked about mental health in security checks to erase the stigma of soldiers stepping forward, Horoho said. As a consequence, “encounters” between mental health professionals and Army personnel jumped to as high as 2.2 million in 2012. But Horoho’s office expects that number to go down to 1.9 million this year. One soldier can have multiple encounters.

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